Cerebral blood flow in the diabetic patient

Faith Pallas, Douglas F Larson

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Diabetes is a major risk factor for cardiovascular disease. Coronary revascularization utilizing cardiopulmonary bypass (CPB) is frequently required for the diabetic patient. Nondiabetic individuals can autoregulate cerebral blood flow (CBF) through metabolic and perfusion pressure mechanisms during CPB. However, it has been reported that diabetic patients have impaired CBF autoregulation during CPB. It is possible, therefore, that impaired CBF autoregulation may contribute to postoperative neuropsychologic dysfunction. The mechanisms for this defect may reside in impaired endothelial-dependent responses in the diabetic that are related to morphological and functional changes linking the vascular endothelium and the vascular smooth muscle. The morphological changes occurring in the diabetic include microangiopathy and macroangiopathy which are characterized by endothelial cell (EC) hyperplasia and basement membrane thickening. Also, significant functional changes in local control of vascular tone, such as an imbalance in the synthesis and secretion of vasoactive factors by the EC and abnormal reactivity of the vascular smooth muscle, are seen in the diabetic when compared to the nondiabetic. More specifically, vascular responses to both calcium-dependent pathways of vasoconstriction and nitric oxide pathways of vasorelaxation have been shown to significantly differ between the diabetic and nondiabetic. The emphasis of this discussion is to examine the molecular mechanisms by which diabetes alters vascular function, with emphasis placed on regulation of cerebral artery blood flow during CPB.

Original languageEnglish (US)
Pages (from-to)363-370
Number of pages8
JournalPerfusion
Volume11
Issue number5
StatePublished - 1996

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Cerebrovascular Circulation
functional change
Cardiopulmonary Bypass
chronic illness
Blood
Blood Vessels
Endothelial cells
Medical problems
Vascular Smooth Muscle
Muscle
Homeostasis
Endothelial Cells
Disease
regulation
Diabetic Angiopathies
Cerebral Arteries
Nitric oxide
Vascular Endothelium
Cell membranes
Vasoconstriction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Cerebral blood flow in the diabetic patient. / Pallas, Faith; Larson, Douglas F.

In: Perfusion, Vol. 11, No. 5, 1996, p. 363-370.

Research output: Contribution to journalArticle

Pallas, F & Larson, DF 1996, 'Cerebral blood flow in the diabetic patient', Perfusion, vol. 11, no. 5, pp. 363-370.
Pallas, Faith ; Larson, Douglas F. / Cerebral blood flow in the diabetic patient. In: Perfusion. 1996 ; Vol. 11, No. 5. pp. 363-370.
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